• Advantages:
• Very effective in preventing pregnancy (failure rates are given below).
• It is (for practical purposes) permanent.
• Sex need not be interrupted to use contraception.
• Disadvantages:
• It requires a minor surgical procedure.
• It takes a while for a vasectomy to be effective.
• Effective contraception is required until azoospermia is confirmed, and this could be 2 or 3 months.
• People may regret having had the procedure:
• The assessment process is designed to ensure that people at risk for regret are identified and fully informed about alternative long-acting reversible contraceptive methods.
• Vasectomy cannot easily be reversed, and the NHS rarely provides reversal procedures.
• Vasectomy does not protect against sexually transmitted infections.
• Small risk of haematoma and infection.
• Rarely, the procedure fails after clearance has been given that there are no spermatozoa in the ejaculate:
• The lifetime failure rate is approximately 1 in 2000 men following negative semen testing.
• Risks:
• There is a small risk of chronic testicular or scrotal pain after vasectomy:
• Chronic testicular or scrotal pain may develop months or years after the vasectomy. The risk of pain adversely affecting the quality of life is small but has not been well quantified by controlled trials. Questionnaire surveys (which are likely to be biased) found testicular or scrotal pain in 12% to 52% of men who had had a vasectomy; between 0.9% and 5.2% sought help or reported that their quality of life was adversely affected.
• A man requesting vasectomy can be reassured that:
• Vasectomy does not increase the risk of testicular cancer or heart disease.
• Vasectomy probably does not increase the risk of prostate cancer. The reported association between vasectomy and prostate cancer is unlikely to be causal.

[RCOG, 2004]